NUR2300 - Nursing - Evidence-based practice report - Assignment Help

NUR2300 Evidence-based practice report Assignment Help

Assignment Task:

Part 1.  Evidence Search  

You will integrate your knowledge and understanding of concepts and principles related to evidence-based practice and contextualise this to an inconsistent clinical practice that you have observed, or a clinical issue or local health need. Specifically, you will define a problem, identify a need for change, and demonstrate understanding of significance of the problem or issue to nursing knowledge and practice reality.

 1. Identify and discuss an inconsistent or little-known approach to clinical practice, a clinical issue or local health need, or a controversial policy that you wish to investigate, to determine whether it is based on evidence, tradition or misconception (What is the problem?).

 2. Summarise the context for the clinical practice or health policy you wish to investigate.

3. Justify and support your rationale for selecting this area of concern to investigate and identify a need for change (What is the significance of the problem? Why do we need to do something about it?)  

4. Then, express this area of concern as a searchable question using the PICO (or other) format. Identify the domain in which your question fits and the best design to answer the question.

 5. Formulate a search strategy using relevant key search terms and search for the best available evidence to answer your searchable question. Attach a one-page printout of your search history as an appendix.  

6. Identify five (5) – 10 (ten) research articles that represents the best available evidence to address your question about the inconsistent/little known practice, policy, or issue. For each article, identify its place on an hierarchy of evidence (e.g. JBI, NHMRC). Attach a one-page evidence summary table containing the relevant details from each article.

7. Justify and support your rationale for choosing each article, addressing the PICO terms and question domain. Note: One of these articles MUST be a systematic review or an evidence-based guideline that you will use in part 2 of this assessment

Part 2. Evidence Report and Recommendations 

You will synthesise the body of research knowledge. Then, you will apply standards/criteria for review and evaluation of the state of the research to critically appraise the highest level of evidence in the topic area that is relevant to your clinical question. Finally, you will formulate recommendations for practice and research and present your argument for change into an evidence summary report.  

1. Synthesise the body of evidence from the five to ten research articles you found ending discussion with your conclusion or ‘bottom line” about what the evidence tells us. 

2. Identify the evidence that is the highest level of evidence addressing the PICO question. Justify and support your rationale as to why this is the best evidence and how it addresses your PICO question.

 3. Identify and select an appropriate tool to appraise the evidence.

 4. Critically appraise the highest level of evidence relevant to your chosen clinical practice or health policy. Justify and support your rationales for your appraisal findings

Outline of Clinical Issue 

o What the issue is, why is it important to address – e.g. why is it significant?  

•  Provide background information, including literature support, on the practice issue that justifies your rationale for choosing this practice problem/scenario /issue to explore further, that is, what is the impact on patients if this problem is not addressed?
•  Prevalence or incidence of the problem  
•  What are the risks in not addressing the problem 4
•  Any key terms or definitions that might describe the clinical issue.
•  Justify to your colleagues why you are using an evidence-based approach to guide your interrogation of current practice

Clinical Question 

•  Identify your clinical question, using the PICO format, that when answered, would help you address the clinical problem/patient care dilemma.  CONSIDER THE FOLLOWING: 
•  Based on your chosen health topic, develop a clear and concise clinical question.  
•  The clinical question must somehow be related to both the clinical issue and nursing practice o Make sure that your question is clearly written as a question, and concludes with a question mark  
•  Identify the domain (eg therapy, human response, meaning, diagnosis, prognosis, harm) of your question. Finish the introduction with a searchable clinical question

Evidence Search

•   During tutorials learning activities, you would have already used the PICO terms of your question as keywords and guides to subject headings, conducted a search for best evidence to answer your question, and used strategies and databases discussed in class.
•  Write a brief yet concise description of your search strategy.  CONSIDER THE FOLLOWING:
•  A description of your evidence-based search strategy  o Recency of information (e.g. you decided to narrow your search to certain years to ensure its currency for practice

How you narrowed your search to find relevant information  o Hierarchy of evidence that you focused on and why  o Types of studies that you considered appropriate to include e.g. qualitative or quantitative or types of study methods used.

 o Key search terms relevant to the clinical question – identify alternative search terms that were also used to help broaden search strategy if required  o Key search strategies - e.g. Boolean operators  o Inclusion or exclusion criteria that you applied and why

 o Publication types e.g. primary research articles, clinical guidelines

•  During tutorials learning activities, you would have already identified and retrieved five sources of “best” evidence relevant to your clinical problem/patient care dilemma, identified the study design for each source and matched this to a level of evidence using either the NHMRC or JBI hierarchy of evidence. You would have also explained why using this level of evidence is the best level of evidence for your clinical question. Write a brief yet concise synopsis of your rationale for selecting the five sources of evidence. Attach a copy of your search strategy and results. 

Literature Synthesis of Best Evidence 

Using an evidence table, identify and extract the key information from each identified evidence source (provide the completed evidence table as an attachment).  In your proposal, briefly yet concisely summarise the key information from your evidence sources

CONSIDER THE FOLLOWING:

o Key findings and conclusions from the across the evidence  

•  Read and re-read each evidence source until you understand it. Using a critical appraisal work sheet appropriate for the domain of your question as a guide, discuss the strengths and limitations of the evidence. Respond to the following three main questions about each evidence source (provide illustrations from the articles and support for your claims):

o Are the results/findings valid/reliable and why?

o What are the results/findings?

o How can I apply the results/findings to patient care

Recommendations for practice change and research 

Discuss factors related to the organisation and the individual health care professional that might act as barriers to evidence-based practice and research utilisation. Explain how the limitations of the evidence found (i.e. the five evidence sources identified) may affect its readiness for implementation into your practice setting.

•   Describe strategies that would facilitate the uptake of evidence and its application in practice.
• Conclude your essay by referring to the evidence-based practice process, summarising the key points of your proposal, and providing a closing statement about supporting consideration of the proposal by the hospital executive.

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